Poor Cognitive Function Is Associated with Obstructive Lung Diseases in Taiwanese Adults
Abstract
:1. Introduction
2. Methods
2.1. The TWB
2.2. Demographic, Laboratory, and Medical Data
2.3. Evaluation of Cognitive Function
2.4. Spirometry Measurements
2.5. Ethics Statement
2.6. Statistical Analysis
3. Results
3.1. Correlations between MMSE with FVC, FEV1, and FEV1/FVC in All Participants
3.2. Correlation between MMSE and FEV1 in the Participants with FEV1/FVC < 70%
3.3. Correlation between MMSE and FVC in the Participants with FEV1/FVC ≥ 70%
4. Discussion
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Petersen, R.C.; Bennett, D. Mild cognitive impairment: Is it Alzheimer’s disease or not? J. Alzheimer’s Dis. JAD 2005, 7, 241–245, discussion 255-62. [Google Scholar] [CrossRef]
- Petersen, R.C.; Smith, G.E.; Waring, S.C.; Ivnik, R.J.; Tangalos, E.G.; Kokmen, E. Mild cognitive impairment: Clinical characterization and outcome. Arch. Neurol. 1999, 56, 303–308. [Google Scholar] [CrossRef]
- Petersen, R.C.; Lopez, O.; Armstrong, M.J.; Getchius, T.S.D.; Ganguli, M.; Gloss, D.; Gronseth, G.S.; Marson, D.; Pringsheim, T.; Day, G.S.; et al. Practice guideline update summary: Mild cognitive impairment: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology. Neurology 2018, 90, 126–135. [Google Scholar] [CrossRef] [PubMed]
- Mitchell, A.J.; Shiri-Feshki, M. Rate of progression of mild cognitive impairment to dementia—meta-analysis of 41 robust inception cohort studies. Acta Psychiatr. Scand. 2009, 119, 252–265. [Google Scholar] [CrossRef] [PubMed]
- Grundman, M.; Petersen, R.C.; Ferris, S.H.; Thomas, R.G.; Aisen, P.S.; Bennett, D.A.; Foster, N.L.; Jack, C.R., Jr.; Galasko, D.R.; Doody, R.; et al. Mild cognitive impairment can be distinguished from Alzheimer disease and normal aging for clinical trials. Arch. Neurol. 2004, 61, 59–66. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Langa, K.M.; Levine, D.A. The diagnosis and management of mild cognitive impairment: A clinical review. JAMA 2014, 312, 2551–2561. [Google Scholar] [CrossRef]
- Dodd, J.W. Lung disease as a determinant of cognitive decline and dementia. Alzheimer’s Res. Ther. 2015, 7, 32. [Google Scholar] [CrossRef] [Green Version]
- Lahousse, L.; Tiemeier, H.; Ikram, M.A.; Brusselle, G.G. Chronic obstructive pulmonary disease and cerebrovascular disease: A comprehensive review. Respir. Med. 2015, 109, 1371–1380. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Pathan, S.S.; Gottesman, R.F.; Mosley, T.H.; Knopman, D.S.; Sharrett, A.R.; Alonso, A. Association of lung function with cognitive decline and dementia: The Atherosclerosis Risk in Communities (ARIC) Study. Eur. J. Neurol. 2011, 18, 888–898. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Weuve, J.; Glymour, M.M.; Hu, H.; Sparrow, D.; Spiro, A., 3rd; Vokonas, P.S.; Litonjua, A.A. Forced expiratory volume in 1 second and cognitive aging in men. J. Am. Geriatr. Soc. 2011, 59, 1283–1292. [Google Scholar] [CrossRef] [Green Version]
- Vidal, J.S.; Aspelund, T.; Jonsdottir, M.K.; Jonsson, P.V.; Harris, T.B.; Lopez, O.L.; Gudnason, V.; Launer, L.J. Pulmonary function impairment may be an early risk factor for late-life cognitive impairment. J. Am. Geriatr. Soc. 2013, 61, 79–83. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Richards, M.; Strachan, D.; Hardy, R.; Kuh, D.; Wadsworth, M. Lung function and cognitive ability in a longitudinal birth cohort study. Psychosom. Med. 2005, 67, 602–608. [Google Scholar] [CrossRef]
- Anstey, K.J.; Windsor, T.D.; Jorm, A.F.; Christensen, H.; Rodgers, B. Association of pulmonary function with cognitive performance in early, middle and late adulthood. Gerontology 2004, 50, 230–234. [Google Scholar] [CrossRef] [PubMed]
- Carroll, D.; Batty, G.D.; Mortensen, L.H.; Deary, I.J.; Phillips, A.C. Low cognitive ability in early adulthood is associated with reduced lung function in middle age: The Vietnam experience study. Thorax 2011, 66, 884–888. [Google Scholar] [CrossRef] [Green Version]
- Arias-Pérez, R.D.; Taborda, N.A.; Gómez, D.M.; Narvaez, J.F.; Porras, J.; Hernandez, J.C. Inflammatory effects of particulate matter air pollution. Environ. Sci. Pollut. Res. Int. 2020, 27, 42390–42404. [Google Scholar] [CrossRef]
- Schraufnagel, D.E.; Balmes, J.R.; Cowl, C.T.; De Matteis, S.; Jung, S.H.; Mortimer, K.; Perez-Padilla, R.; Rice, M.B.; Riojas-Rodriguez, H.; Sood, A.; et al. Air Pollution and Noncommunicable Diseases: A Review by the Forum of International Respiratory Societies’ Environmental Committee, Part 2: Air Pollution and Organ Systems. Chest 2019, 155, 417–426. [Google Scholar] [CrossRef]
- Power, M.C.; Adar, S.D.; Yanosky, J.D.; Weuve, J. Exposure to air pollution as a potential contributor to cognitive function, cognitive decline, brain imaging, and dementia: A systematic review of epidemiologic research. Neurotoxicology 2016, 56, 235–253. [Google Scholar] [CrossRef] [Green Version]
- Chen, C.H.; Yang, J.H.; Chiang, C.W.K.; Hsiung, C.N.; Wu, P.E.; Chang, L.C.; Chu, H.W.; Chang, J.; Song, I.W.; Yang, S.L.; et al. Population structure of Han Chinese in the modern Taiwanese population based on 10,000 participants in the Taiwan Biobank project. Hum. Mol. Genet. 2016, 25, 5321–5331. [Google Scholar] [CrossRef] [Green Version]
- Fan, C.T.; Hung, T.H.; Yeh, C.K. Taiwan Regulation of Biobanks. J. Law Med. Ethics J. Am. Soc. Law Med. Ethics 2015, 43, 816–826. [Google Scholar]
- Levey, A.S.; Bosch, J.P.; Lewis, J.B.; Greene, T.; Rogers, N.; Roth, D. A more accurate method to estimate glomerular filtration rate from serum creatinine: A new prediction equation. Modification of Diet in Renal Disease Study Group. Ann. Intern. Med. 1999, 130, 461–470. [Google Scholar] [CrossRef]
- Folstein, M.F.; Folstein, S.E.; McHugh, P.R. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J. Psychiatr. Res. 1975, 12, 189–198. [Google Scholar] [CrossRef]
- Miller, M.R.; Hankinson, J.; Brusasco, V.; Burgos, F.; Casaburi, R.; Coates, A.; Crapo, R.; Enright, P.; van der Grinten, C.P.; Gustafsson, P.; et al. Standardisation of spirometry. Eur. Respir. J. 2005, 26, 319–338. [Google Scholar] [CrossRef] [Green Version]
- Lutsey, P.L.; Chen, N.; Mirabelli, M.C.; Lakshminarayan, K.; Knopman, D.S.; Vossel, K.A.; Gottesman, R.F.; Mosley, T.H.; Alonso, A. Impaired Lung Function, Lung Disease, and Risk of Incident Dementia. Am. J. Respir. Crit. Care Med. 2019, 199, 1385–1396. [Google Scholar] [CrossRef] [Green Version]
- Knopman, D.S.; Gottesman, R.F.; Sharrett, A.R.; Wruck, L.M.; Windham, B.G.; Coker, L.; Schneider, A.L.; Hengrui, S.; Alonso, A.; Coresh, J.; et al. Mild Cognitive Impairment and Dementia Prevalence: The Atherosclerosis Risk in Communities Neurocognitive Study (ARIC-NCS). Alzheimer’s Dement. 2016, 2, 1–11. [Google Scholar] [CrossRef] [Green Version]
- Singh, B.; Mielke, M.M.; Parsaik, A.K.; Cha, R.H.; Roberts, R.O.; Scanlon, P.D.; Geda, Y.E.; Christianson, T.J.; Pankratz, V.S.; Petersen, R.C. A prospective study of chronic obstructive pulmonary disease and the risk for mild cognitive impairment. JAMA Neurol. 2014, 71, 581–588. [Google Scholar] [CrossRef]
- Rusanen, M.; Ngandu, T.; Laatikainen, T.; Tuomilehto, J.; Soininen, H.; Kivipelto, M. Chronic obstructive pulmonary disease and asthma and the risk of mild cognitive impairment and dementia: A population based CAIDE study. Curr. Alzheimer Res. 2013, 10, 549–555. [Google Scholar] [CrossRef]
- Hung, W.W.; Wisnivesky, J.P.; Siu, A.L.; Ross, J.S. Cognitive decline among patients with chronic obstructive pulmonary disease. Am. J. Respir. Crit. Care Med. 2009, 180, 134–137. [Google Scholar] [CrossRef]
- Soriano, J.B.; Visick, G.T.; Muellerova, H.; Payvandi, N.; Hansell, A.L. Patterns of comorbidities in newly diagnosed COPD and asthma in primary care. Chest 2005, 128, 2099–2107. [Google Scholar] [CrossRef]
- Van Eeden, S.; Leipsic, J.; Paul Man, S.F.; Sin, D.D. The relationship between lung inflammation and cardiovascular disease. Am. J. Respir. Crit. Care Med. 2012, 186, 11–16. [Google Scholar] [CrossRef]
- Stone, I.S.; Barnes, N.C.; Petersen, S.E. Chronic obstructive pulmonary disease: A modifiable risk factor for cardiovascular disease? Heart 2012, 98, 1055–1062. [Google Scholar] [CrossRef]
- Barnes, P.J. Chronic obstructive pulmonary disease: Effects beyond the lungs. PLoS Med. 2010, 7, e1000220. [Google Scholar] [CrossRef]
- Biko, A.; Horváth, A.; Tomisa, G.; Bártfai, L.; Bártfai, Z. Changes in the Burden of Comorbidities in Patients with COPD and Asthma-COPD Overlap According to the GOLD 2017 Recommendations. Lung 2018, 196, 591–599. [Google Scholar] [CrossRef]
- Yaffe, K.; Laffan, A.M.; Harrison, S.L.; Redline, S.; Spira, A.P.; Ensrud, K.E.; Ancoli-Israel, S.; Stone, K.L. Sleep-disordered breathing, hypoxia, and risk of mild cognitive impairment and dementia in older women. JAMA 2011, 306, 613–619. [Google Scholar] [CrossRef] [Green Version]
- Maclay, J.D.; MacNee, W. Cardiovascular disease in COPD: Mechanisms. Chest 2013, 143, 798–807. [Google Scholar] [CrossRef]
- Kamil, F.; Pinzon, I.; Foreman, M.G. Sex and race factors in early-onset COPD. Curr. Opin. Pulm. Med. 2013, 19, 140–144. [Google Scholar] [CrossRef] [Green Version]
- Swigris, J.J.; Olson, A.L.; Huie, T.J.; Fernandez-Perez, E.R.; Solomon, J.; Sprunger, D.; Brown, K.K. Ethnic and racial differences in the presence of idiopathic pulmonary fibrosis at death. Respir. Med. 2012, 106, 588–593. [Google Scholar] [CrossRef] [Green Version]
Characteristics | Normal (n = 357) | Restrictive (n = 95) | Obstructive (n = 231) | p |
---|---|---|---|---|
Age (year) | 63.9 ± 2.8 | 64.9 ± 2.8 * | 64.1 ± 3.0 | 0.011 |
Male gender (%) | 52.4 | 56.8 | 41.6 *,† | 0.011 |
Smoking history (%) | 23.5 | 34.7 | 25.1 | 0.082 |
DM (%) | 10.1 | 16.8 | 12.1 | 0.186 |
Hypertension (%) | 22.7 | 30.5 | 22.5 | 0.244 |
Asthma history (%) | 3.4 | 6.3 | 4.8 | 0.399 |
Emphysema or bronchitis history (%) | 3.4 | 2.1 | 5.2 | 0.340 |
Regular exercise habits (%) | 73.7 | 61.1 | 69.7 | 0.053 |
Midnight snack habits (%) | 19.9 | 21.1 | 16.9 | 0.573 |
BMI (kg/m2) | 24.3 ± 3.0 | 24.7 ± 3.5 | 24.1 ± 2.9 | 0.242 |
SBP (mmHg) | 124.2 ± 16.1 | 130.2 ± 19.3 * | 125.9 ± 17.8 | 0.010 |
DBP (mmHg) | 72.2 ± 10.7 | 73.3 ± 11.5 | 71.5 ± 11.1 | 0.373 |
Laboratory parameters | ||||
Fasting glucose (mg/dL) | 101.2 ± 21.2 | 101.3 ± 18.9 | 103.2 ± 26.0 | 0.569 |
Triglyceride (mg/dL) | 100 (72-138.5) | 105 (80-141) | 101 (74-131) | 0.468 |
Total cholesterol (mg/dL) | 199.6 ± 36.4 | 197.2 ± 39.6 | 205.4 ± 36.8 | 0.093 |
Hemoglobin (g/dL) | 14.1 ± 1.4 | 14.1 ± 1.5 | 13.9 ± 1.3 | 0.279 |
eGFR (mL/min/1.73 m2) | 86.8 ± 27.2 | 85.5 ± 34.4 | 90.6 ± 27.2 | 0.188 |
Uric acid (mg/dL) | 5.7 ± 1.4 | 6.1 ± 1.5 | 5.6 ± 1.4 † | 0.036 |
MMSE | 27.1 ± 2.5 | 26.7 ± 2.8 | 26.5 ± 3.1 | 0.052 |
MMSE < 24 | 7.8 | 12.6 | 16.9 * | 0.003 |
Lung function | ||||
FVC (L) | 2.8 ± 0.6 | 2.1 ± 0.5 * | 2.4 ± 0.7 *,† | <0.001 |
FVC-predicted (%) | 95.0 ± 10.8 | 71.3 ± 8.5 * | 87.3 ± 17.4 *† | <0.001 |
FEV1 (L) | 2.3 ± 0.5 | 1.7 ± 0.4 * | 1.3 ± 0.5 *,† | <0.001 |
FEV1-predicted (%) | 101.2 ± 13.7 | 78.2 ± 12.0 * | 59.8 ± 19.3 *,† | <0.001 |
FEV1/FVC (%) | 82.5 ± 5.8 | 82.6 ± 6.4 | 52.8 ± 13.3 *,† | <0.001 |
Lung Function | Multivariable Stepwise | |
---|---|---|
Unstandardized Coefficient β (95% CI) | p | |
FVC (L) | ||
Age (per 1 year) | −0.033 (−0.046, −0.021) | <0.001 |
Male vs. female | 0.899 (0.798, 1.001) | <0.001 |
Smoking history | −0.103 (−0.196, −0.010) | 0.030 |
Asthma history | −0.240 (−0.413, −0.067) | 0.007 |
Emphysema or bronchitis history | −0.213 (−0.396, −0.031) | 0.002 |
Regular exercise habits | 0.097 (0.020, 0.174) | 0.014 |
SBP (per 1 mmHg) | −0.002 (−0.004, 0) | 0.019 |
eGFR (per 1 mL/min/1.73 m2) | −0.002 (−0.003, 0) | 0.036 |
MMSE (per 1 score) | 0.018 (0.005, 0.030) | 0.008 |
FEV1 (L) | ||
Age (per 1 year) | −0.018 (−0.033, −0.004) | 0.013 |
Male vs. female | 0.817 (0.721, 0.914) | <0.001 |
Smoking history | −0.151 (−0.261, −0.042) | 0.007 |
SBP (per 1 mmHg) | −0.003 (−0.005, 0) | 0.031 |
MMSE (per 1 score) | 0.021 (0.006, 0.036) | 0.007 |
FEV1/FVC (%) | ||
Male vs. female | 4.593 (0.451, 8.735) | 0.030 |
Total cholesterol (per 1 mg/dL) | −0.044 (−0.081, −0.006) | 0.023 |
MMSE (per 1 score) | 0.475 (0.003, 0.948) | 0.049 |
FEV1 (L) | Multivariable Stepwise | |
---|---|---|
Unstandardized Coefficient β (95% CI) | p | |
Male vs. female | 0.526 (0.414, 0.639) | <0.001 |
MMSE (per 1 score) | 0.019 (0.001, 0.037) | 0.041 |
FVC (L) | Multivariable Stepwise | |
---|---|---|
Unstandardized Coefficient β (95% CI) | p | |
Age (per 1 year) | −0.032 (−0.047, −0.018) | <0.001 |
Male vs. female | 0.906 (0.824, 0.989) | <0.001 |
SBP ( per 1 mmHg) | −0.004 (−0.006, −0.001) | 0.004 |
Regular exercise habits | 0.123 (0.033, 0.213) | 0.008 |
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Hsieh, S.-W.; Wu, D.-W.; Wang, C.-W.; Chen, S.-C.; Hung, C.-H.; Kuo, C.-H. Poor Cognitive Function Is Associated with Obstructive Lung Diseases in Taiwanese Adults. Int. J. Environ. Res. Public Health 2021, 18, 2344. https://doi.org/10.3390/ijerph18052344
Hsieh S-W, Wu D-W, Wang C-W, Chen S-C, Hung C-H, Kuo C-H. Poor Cognitive Function Is Associated with Obstructive Lung Diseases in Taiwanese Adults. International Journal of Environmental Research and Public Health. 2021; 18(5):2344. https://doi.org/10.3390/ijerph18052344
Chicago/Turabian StyleHsieh, Sun-Wung, Da-Wei Wu, Chih-Wen Wang, Szu-Chia Chen, Chih-Hsing Hung, and Chao-Hung Kuo. 2021. "Poor Cognitive Function Is Associated with Obstructive Lung Diseases in Taiwanese Adults" International Journal of Environmental Research and Public Health 18, no. 5: 2344. https://doi.org/10.3390/ijerph18052344